The judicial role in life-sustaining medical treatment decisions.

Although there has been speculation regarding the pervasiveness and nature of judicial decisions regarding life-sustaining medical treatment (LSMT), no attempt has been made to empirically assess their prevalence or the issues they address. An exploratory study utilizing a mail survey of a nationwide random sample (N = 905) of state trial court judges was conducted to provide initial information regarding this decision-making process. Twenty-two percent of the responding judges had heard at least one LSMT case, and judicial review did not appear endemic to particular states. The number of judges hearing LSMT cases dropped from 1975 to 1981 but has increased since then. Three major issues predominate: patient competency, appointment of a surrogate decisionmaker, and resolution of the ultimate issue of forgoing LSMT. Relatively few cases either contested a prior directive's validity or involved imposing sanctions for instituting or forgoing LSMT. Although subject to different interpretations, the results suggest the courts are having a significant impact on certain aspects of the LSMT decision-making process. However, the infrequency with which any one judge is called upon to make an LSMT decision causes concern about the judiciary's ability to respond in a timely and appropriate manner. With their potential for a profound effect on the actions of health care providers, greater attention to this decision-making process is warranted.     

A unique case of congenital bilateral absence of parietal bones in a neonate

The remains of an unidentified female neonate were discovered in a field in central Missouri. Examination revealed bilateral absence of the parietal bones. A search of the literature describing similar defects suggests that the present case represents a unique condition, described here for the first time.     

Juvenile Criminality And Semi-Criminality: Learning From Victorian Perceptions And Responses

This article focuses on media reportage of offensive juveniles, past and present, to elicit lessons that the twenty-first century can learn from the Victorian past in terms of diversionary responses. How to prevent vulnerable juveniles sliding into dangerous criminality is a continuing preoccupation: the issue explored in this article relates to the creation of the identity of the criminal juvenile. In utilising the concept of semi-criminality to label certain types of juvenile anti-social behaviour the Victorians avoided actual criminalisation of socially offensive but, in legal terms, minor behaviours. The reasons for and negative consequences of the abandonment of this concept by the modern age are explored, including the reconceptualisation of where responsibility for juvenile offending lies in the modern era.     

Miscarriage of Justice? Postcolonial Reflections on the ‘Trial’ of the Maharajah of Baroda, 1875

This article revisits the Baroda Incident 1875, providing a detailed examination of the Enquiry or ‹trial’ for the first time, and locating that examination in the wider socio-cultural context of the nineteenth century British Empire (especially the Raj) and the exporting of the ‹British’/English legal culture to the Empire. The implications of the establishing of British principles of justice, including the value placed upon Indian-generated evidence and testimony by the courts, are explored, in order to establish the Baroda Incident as a significant miscarriage of justice. Using historical methodologies as well as postcolonial insights, it demonstrates that the concepts of justice on which the British prided themselves were intrinsincally racialised as well as gendered, with profound modern resonances. Dr. Judith Rowbotham is a Reader, School of Arts and Humanities, Nottingham Trent University.     

Competitive Liberalization,Competitive Imperialism,and Intellectual Property

Aggressive pursuit of free trade agreements (FTAs) and customs unions (CUs) by major and minor trading powers alike challenges the conventional wisdom in favor of such pursuit – competitive liberalization. An equally plausible explanation for an active bilateral and regional trade agreement policy, one which effectively de-emphasizes multilateralism, may be competitive imperialism. The protection and enforcement of intellectual property rights is one area in which new provisions, going beyond multilateral rules, are being negotiated and written into FTAs and CUs. Such provisions may yield insights into which characterization of bilateralism and regionalism – competitive liberalization or competitive imperialism – is more apt. Rice Distinguished Professor, The University of Kansas, School of Law, Green Hall, 1535 West 15th Street, Lawrence, KS 66045-7577, USA. Tel. +1-785-8649224. Fax. +1-785-8645054. www.law.ku.edu. J.D., Harvard (1989); M.Sc., Oxford (1986); M.Sc., London School of Economics (1985); A.B., Duke (1984). Marshall Scholar (1984-86). Member, Council on Foreign Relations, Royal Society for Asian Affairs, and Fellowship of Catholic Scholars. Author, Modern GATT Law (Sweet & Maxwell 2005), International Trade Law: Theory and Practice (2nd ed. 2000, 3rd ed. forthcoming 2007-08), and Trade, Development, and Social Justice (Carolina Academic Press 2003). I am thankful to my Research Assistant, Mr. David R. Jackson (B.A., George Mason University, 1992; J.D. Class of 2007, University of Kansas), for his indispensable help on this work. I also am grateful to Dr. Mohammed El Said, University of Central Lancashire (UCLAN), for his consistent support and friendship, and for what he has taught and continues to teach me about international trade and intellectual property.     

从红色威胁到激进民众主义——拉丁美洲对美国的非安全因素

*2004年11月,美国总统乔治.W.布什在阿根廷参加第4届美洲国家首脑会议期间,受到了来自民众的强烈抗议。这是自1958年时任美国副总统的理查德.M.尼克松在委内瑞拉被愤怒的民众投掷石块以来,美国政府高级官员在拉丁美洲受到的最差的待遇了。在委内瑞拉总统乌戈.查韦斯和玻利维亚总统候选人埃沃.莫拉莱斯的鼓舞和煽动下,数万名民众举行集会,谴责美帝国主义和已遭搁浅的美洲自由贸易区计划。布什会受到强烈抗议,事先并非毫无征兆。在他出访前夕进行的民意调查显示,53%的南美洲人和87%的拉美“意见领袖”(Opinion Leaders)对美国总统表示反感,…     

Has PPS increased Medicare expenditures on physicians?

We use data from 1983 and 1985 on the volume of Medicare physician services to analyze whether Medicare's Prospective Payment System (PPS), which resulted in a significant decline in hospital spending, led to a partially offsetting increase in real expenditures for physician services. We also analyze the effect of increases in assignment rates, increasing incomes of the elderly, and other factors on real expenditures during this period. Our main conclusion is that PPS has at most a small positive effect on real physician expenditures. Because people spent less time in the hospital, Medicare physician spending declined; but because of incentives to shift radiology and other services out of the hospital, some of this decline was offset. We also conclude that the sharp increase in Medicare assignment rates over this period, along with the rising incomes of the elderly during this period, contributed to the observed growth.